Application of serum total bilirubin in patients with chronic obstructive pulmonary disease in acute exacerbation stage

Objective To explore the level of serum total bilirubin (TBIL) in chronic obstructive pulmonary disease (COPD) patients in acute exacerbation (AE) stage and its correlation with pulmonary function. Methods A total of 73 AECOPD patients and 35 healthy subjects were enrolled. Their levels of serum TBIL in both groups were determined before and after treatment. The correlation between serum TBIL level and pulmonary function parameters were analyzed. Results AECOPD patients presented remarkably decreased levels of serum TBIL than healthy subjects (P<0.05). There were 21 patients suffering from respiratory failure, among 73 AECOPD patients. Marked decreases were found in the level of serum TBIL in AECOPD patients with respiratory failure, compared with those without respiratory failure (P<0.05). The levels of serum TBIL were gradually decreased in GOLD grades 1-2, 3, and 4 patients, where statistical differences were found (P<0.05). AECOPD patients presented significantly higher levels of TBIL on discharge, compared with the levels at admission (P<0.05). The level of TBIL was positively correlated with FEV1 and FEV1/FVC inj AECOPD patients (r=0.911 and 0.779, respectively, P<0.05). Conclusions The level of serum TBIL is associated with aggravated outcomes in COPD patients. The decreased level of serum TBIL in AECOPD patients were negatively correlated with the severity of disease, which suggests that the measurement of serum TBIL is helpful for the evaluation of AECOPD.